A new article by
scientists from the International Food Policy Research Institute (IFPRI) in Washington,
DC, USA, published in the Journal of Nutrition, has pointed out that vegan babies
and young children in India are at an increased risk for stunting – which means being
too small for their age. However, it seems likely that many of the “vegan”
mothers and children in this study were extremely poor people were not vegans
by choice, but who did not eat animal products (or hardly any) because they
were so poor.
The cause of stunting are usually
nutritional deficiencies. Obviously, people who are very poor and do not have
enough food or can only afford to eat white rice and nothing much else, will likely
suffer many nutritional deficiencies.
“FIGURE 2 A map of the prevalence of lactovegetarianism among Indian
mothers. […] Estimated from the 2015–2016 NFHS [National Family Health Survey
(India)] using the women’s survey weights. LVG, lactovegetarianism.
The article also states that “Most
existing estimates suggest that just under one-third of the majority Hindu
population is lactovegetarian (mostly upper castes), with smaller subsets of
the population being lactoovovegetarian, lactopescatarian, or vegan.”
The actual percentage of real vegans
in India, i.e. vegans who are vegans by choice, not out of poverty is not
really known currently, as far as I know.
The article also states: “At the
national level, 22.7% of mothers in the NFHS were lactovegetarian, 3.4% were lacto-ovovegetarian,
and few were lactopescatarian (0.06%) or vegan (1.1%). Among the Hindu
population, 27.3% were lactovegetarian, but lactovegetarian was most prevalent among
the small Jain population (89.4%), Sikhs (62.4%), and was very rare among
Muslims and Christians.” (Not a surprise.)
Second, the study found that “Compared
with children of nonvegetarian mothers, children aged 24–59 [months] of
lactovegetarian mothers were 2.9 percentage points […] less likely to
be stunted and children aged 6–23 [months] were 1.6 points less likely to be
wasted [too skinny; body weight too low for body height], whereas children aged
6–23 [months] with vegan mothers were 5.2
points more likely to be stunted […].
This means that the lacto-vegetarian
children actually had a lower risk than the non-vegetarian children.
But the vegan children had a higher
risk to be too small than the non-vegetarian children.
Two things are important to mention
about this result: (1) As already mentioned, very likely these “vegans” were
not actually vegans, but extremely poor people, and (2) this higher risk was
present only in the “vegan” children aged 6–23 months, but not anymore in a
statistically significant way at the age of 24–59 months (= 2–5 years old; see table
3 below).
This second point is actually quite
surprising to me. Imagine extremely poor people who cannot afford any animal
products, and probably not many fruits and vegetables or even legumes. One
would assume that many more of these children would end up with terrible
deficiencies, including severe vitamin B12 deficiency.
“Vegans” in this study were defined
in this way: “Vegan mothers are defined as those who report never consuming
dairy, eggs, meat, or fish.”
Now, I am assuming (!) that most of
these “vegans” were not real vegans. I cannot say so for sure, but I have very
good reasons to assume this:
(1) From what I know a vegan diet
because of tradition and/or religion is very uncommon in India.
(2) There are no ancient religious
or cultural groups in India who are traditionally vegan – as far as I know.
(3) Vegan diets and veganism are
really gaining in popularity in India (like elsewhere) but more among more
educated, wealthier, more English-speaking people – as far as I know. Veganism in
the mainstream – even if vegans were just 1% of the population – is a new phenomenon
in India. Likely actual vegans make up much less than 1% of the population in
India, and most vegans in India are “new” vegans.
(4) From the information in table 1 (see
below) it seems that a “vegan” diet was more common among the poorest and among
lower caste mothers – and I would suspect that these “vegans” were vegan mostly
due to poverty.
(5) Because the “vegan” children
were only more likely to be stunted at age 6–23 months and not anymore at the
age of 24–59 months, this makes it seem like the children recovered quickly,
and actually just grew more slowly than the other dietary groups. This confirms
my suspicion that these children were actually neither real vegans, nor were
they even 100% dietary vegans due to poverty, because I would expect extreme deficiencies
in very poor children who did not have enough food, not enough food variety, and
no B12 supplements.
This study included more than
220,000 children, and about 1% of these children were “vegan” children, so
about 2200 children. It is very likely that there aren’t that many vegan
children in this age group in India. Please do correct me if I’m wrong.
The article states:
“Children of vegan mothers were
significantly more likely to be stunted [too small], wasted [too skinny], or anemic
[likely due to deficiency in iron and/or vitamin B12] than nonvegetarian
children, and the differences were relatively large (8.8 percentage points in
the case of stunting).”
“In contrast, children of vegan
mothers were 5.2 points more likely to be stunted in the 6–23 [months] age
group, whereas the associations for the other age ranges were not statistically
significant.
“Relative to nonvegetarian mothers,
there were no significant differences [in terms of wasting, i.e. being too
skinny] for the smaller groups of children of lactopescatarian mothers or children
of vegan mothers.”
“We found some evidence that
children of vegan mothers are more likely to experience diarrhea […].”
The article concludes with possible
explanations why the “vegan” children were at a higher risk of stunting: Well,
obviously because they did not consume dairy.
“In contrast, children of vegan
mothers, who constitute just 1.1% of sampled Indian mothers, are at a
substantially increased risk of stunting in the 6–23 mo age range.
We explored several hypotheses that
might explain these results.
First, we found that lactovegetarian
mothers and their children are significantly more likely to consume dairy
products frequently and potentially in larger quantities, and that more frequent
dairy consumption by mothers predicted a significantly lower risk of stunting
and wasting in their children.”
Well, unsurprisingly, the lacto-vegetarian
children consumed MORE dairy than the allegedly “vegan” children.
And … dairy in fact is a rich source
of vitamin B12, protein, and calcium, and zinc, and calories, and other
nutrients that are less relevant here. Quite possibly, dairy is also a relevant
source of iodine – in “Western” countries dairy contains high amounts of iodine
because dairy cows are given iodine-fortified fodder and because
iodine-containing disinfectants are used to clean their udders and the milking
machines.
This last point is a very important
take home message for real vegans in India:
- Make sure your vegan children get enough vitamin B12 – give them a supplement.
- Make sure your vegan children get enough protein, iron, calcium, zinc, and omega 3 fatty acids. You can see good vegan sources here – but use smaller amounts for children.
- Make sure your children eat a large variety of fruit, vegetables, grains, legumes, and nuts/seeds.
The article also – wrongly – points out
that “Traditional Indian diets dominated by rice and pulses will have
inadequate lysine content […].” Pulses (= legumes), i.e. beans, lentils, peas,
chickpeas, soya, mung dhal, etc. are excellent sources of the amino acid
lysine. Make sure to include both grains (like rice, wheat, etc.) and legumes
in your vegan diet.
Take home message: Researchers
should differentiate between real vegans who are vegans by choice, and people
who are very poor and cannot afford to buy any animal products who are not
actual vegans.
Take home message: Maybe large-scale
vitamin B12 flour fortification in India will one day become a reality.
More info:
Search for “India” on this blog.
See my vitamin B12 recommendations for
vegans – 5 to 10 µg per day for vegan children is fine – here:
In English
In Hindi
In Gujarati
In Kannada
… and many other languages
Find more excellent India-specific vegan
nutrition info on the Vegan Outreach India website. Jack Norris,
Vegan Outreach’s president, is a registered dietitian (RD) and a long-term
pioneer of vegan nutrition education.
(Obviously, I'm not responsible for content on other websites.)
Also, if you’re interested: How should
vegan children grow?
Reference:
Headey and Palloni: Stunting and
Wasting Among Indian Preschoolers have Moderate but Significant Associations
with the Vegetarian Status of their Mothers; Journal of Nutrition 2020
Mar 14. pii: nxaa042. doi: 10.1093/jn/nxaa042 . [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/32171005